Abstract
Injury prevention frameworks are critical for preventing musculoskeletal injury and improving rehabilitation outcomes. However, their relative successes in translation arguably rely on two interlinked components: (1) the quality of the empirical evidence used to develop the intervention (content), and (2) the effective application of behavior change and motivation principles to optimise participant adherence and engagement (delivery). The purpose of this commentary is to develop an injury prevention and rehabilitation framework using the best available physics-based simulation, biomechanics, and behavior change research. The intervention as a whole is entitled biomechanically-informed training (BIT). While investigators have previously examined the relative merits of different training genres (e.g., plyometric, balance, resistance), what makes BIT novel is that it explicitly targets the biomechanical mechanisms that mitigate musculoskeletal injury risk (i.e., force) in ways that are underpinned by established behavior change principles. The four pillars of BIT refer to focused exercise use, irrespective of the training genre, to improve an individual’s: (1) knee flexion dynamics, (2) dynamic trunk control, (3) gastrocnemius muscle strength, and (4) hip muscular strength. We also present experimental data from two independent training studies verifying the efficacy of BIT for the prevention of knee and anterior cruciate ligament (ACL) injury.
Highlights
Technological advancements such as the invention of stop-action photography [1], the force platform [2], and the programmable computer have elevated the field of biomechanics as an important research discipline within the human sciences [3]
Governments and health practitioners are aware of these anterior cruciate ligament (ACL) injury statistics, and substantial research attention has been devoted to lower limb and ACL injury/re-injury prevention as well as rehabilitation
Outcomes from this research have proven in principle that combinations of different training genres, such as balance, plyometric, resistance, and/or technique training can be used to reduce the lower limb and ACL injury risk among adolescent female populations (
Summary
Technological advancements such as the invention of stop-action photography [1], the force platform [2], and the programmable computer have elevated the field of biomechanics as an important research discipline within the human sciences [3]. Biomechanists must collaborate with coaches and clinicians to better understand the nuanced difference between establishing training programs based on scientifically proven principles (e.g., the program proposed in this paper), compared with intuitively designed programs. It is the biomechanical underpinnings of a program that may shape injury prevention and rehabilitation outcomes. Regardless of the quality of program content, it is imperative that participants (e.g., athletes, patients) engage fully in a program in order to derive the intended benefits [4] In this respect, behavior change principles and motivation theory play an important role in the application and successful delivery of empirically designed programs. In the material that follows, we will present the foundation of biomechanically-informed training (BIT), which is the program (e.g., four pillars), and the psychological and behavior change principles the program is built upon
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